Portal Vein Embolization Under Different Hepatic Fibrosis Stages:a Study Of Regeneration Effect And Pattern

Purpose: To explore the effect and pattern of liver compensatory hyperplasia induced byportal vein embolization in different fibrosis stages.Methods: Application of CCl4establish the rabbit model of liver fibrosis stage, Liverpuncture biopsy pathological diagnosis as standard in stages, the rabbit model can bedivided into mild liver fibrosis group, the moderate group and severe group, groups areunder B ultrasound, the application of microsphere for left main portal vein embolization,randomly selected6experimental rabbit from each group before portal vein embolizationoperation and after7days,14days,21days,28days and35days, The volume of the left lobe、the none embolization lobe and the whole liver were measured by dissection watercapacity method, calculated redistribution volume ratio of none embolization lobe, drawthe time correlation curve of liver compensatory hyperplasia; took blood sampling fromheart before portal vein embolization operation and after7days,14days,21days,fordetermining general liver function; After execution of experimental animals, rightpathological staining for the liver tissue slice, comparing the differences of regenerativeliver tissue and liver tissue histological.Results: Between the each point in time，there was no statistically significant difference ofgeneral liver function within the group;35days after embolization, the volumeregeneration of the none embolization lobe were21.2±5cm³、16.5±4cm³、14.7±4.5cm³，increased by73%,56%,43%, Mild group and moderate and severe groups have significantdifference(t_1、2=2.412，P=0.037、t_1、3=3.275，P=0.008；P<0.05), difference betweenmoderate group and severe group was not significan(t_2、3=0.945，P=0.367；P>0.05).7daysafter PVE,the difference of liver regeneration volume between mild group, medium group,severe group was statistically significant(T_1、2=5.80,P=0.000、t_1、3=5.078,P=0.000、t_2、3=5.078,P=0.002；P<0.05),14days after PVE, both the Mild group and the moderate grouphad statistically significant difference to the severe group in liver regeneration volume(t1、3=6.019,P=0.000、t_2、3=4.339,P=0.004；P<0.05),21days after PVE, both the Mild group andthe moderate group had statistically significant difference to the severe group in liverregeneration volume(t_1、3=-5.719,P=0.001，t_2、3=-4.842,P=0.001；P<0.05),35days after PVE,the liver regeneration volume between Mild group and severe group had statisticallysignificant difference(T_1、3=0.00,P=0.000).In Mild group, the none embolization lobevolume at7days after PVE had statistically significant difference to the day before PVE（t0、7=-2.508，P=0.033）, the redistribution volume ratio had statistically significant differenceat0day、7day and14day time poin(t_0、7=-4.195，P=0.002、t_7、14=-4.215，P=0.002；P<0.05),the none embolization lobe volume growth compared with pve respectively increasedby32%、25%、10%、4%、2%at each time point after PVE; In Moderate group, the noneembolization lobe volume at14days after PVE had statistically significant difference tothat before PVE(t_0、14=-2.331，P=0.044), the redistribution volume ratio had statisticallysignificant difference at7day and14day time poin(t_0、14=-3.784，P=0.004、t_7、14=-2.493，P=0.032；P<0.05), the none embolization lobe volume growth compared with pverespectively increased by16%、20%、11%、6%、6%at each time point after PVE; In Severegroup, the none embolization lobe volume at21days after PVE had statistically significant difference to the day before PVE(t_0、21=-2.707，P=0.023), the redistribution volume ratiohad statistically significant difference at14day and21day time poin(t_0、7=-4.195，P=0.002、t_7、14=-4.215，P=0.002；P<0.05), the none embolization lobe volume growth compared withpve respectively increased by7%、10%、19%、6%、2%at each time point after PVE(t_0、21=-4.813，P=0.001、t_14、21=-2.399，P=0.038；P<0.05).Conclusion: As the different stages of liver fibrosis, the effect and mode of liverregeneration induced by PVE have significant differences.